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Very little is known about Sarah's early life, although the BAU's profile indicates she may have been sexually abused by a father figure. As an adult, Sarah became a medical student at Tulane University. One night, on February 19, 1998, she was in a bar called "Jones" with some friends during Mardi Gras. A man flirted with her and managed to lure her away from her friends to an empty pool room where he and a friend raped her[1]. She pressed charges, but the detectives investigating the case, William LaMontagne, Sr., and J.R. Smith, came to disagree about details regarding the credibility of her story. LaMontagne believed her, while Smith, who knew one of the offenders, convinced her to drop the charges on the grounds that it most likely wouldn't lead to a conviction. She dropped out of medical school five days later. At some unknown point, she apparently became obsessed with the (in)famous serial killer Jack the Ripper and, on August 2005, began killing in a fashion similar to the killer.

Meanwhile, Detective LaMontagne had been transferred from sex-crimes to homicide and investigated Sarah's first three murders. Eventually obsessing over the case, he refused to leave New Orleans, despite the arrival of Hurricane Katrina. One night, while looking over the notes, crime scene photos, and letters regarding the murders, he realized who the unsub was when he noticed a bar stamp on the hand of a victim; the mark of Jones, the bar in which Sarah was raped. Just after he realized it, a tree was flung by the storm through a window, hitting and mortally wounding him. He managed to use a piece of broken glass to carve the name "Jones" into the wall before dying. Unfortunately, the storm had washed away the bodies of the first three victims, their autopsy reports, and all of the other evidence. It was assumed by the police that Sarah died in the storm, but really she, like many other Katrina survivors, transferred to Galveston, Texas, during which time she killed another man in October 2006 and removed one of his kidneys, to further match the Ripper's M.O.

In 2007, Sarah returns to New Orleans and restarts her killings in the French Quarters, near the anniversary of when she dropped out of medical school. LaMontagne's son, Detective William LaMontagne, Jr., is investigating the crime and called for the BAU. After she kills her sixth victim, the team realizes she is copying Jack the Ripper. Finally realizing what "Jones" means, Will figures out the message his father left and learns that Sarah is the unsub. They track her down to a motel, where she is about to mutilate a man she seduced. Held at gunpoint with a knife in her hand, Sarah suggests that the BAU kill her. However, she is talked into surrendering by Will when she finds out that his father, whom she deeply respected, was killed in Katrina.

Sarah targeted Caucasian men aged in their early 20s to mid-40s, presumably as surrogates for her assailants. She would lure them at night, away from crowds, pubs, and the like in the French Quarter (except for her fifth victim, who was killed in Texas due to her having to relocate after Hurricane Katrina) by seducing them with promises of sex. One of her victims was lured from Jones, the same bar she was raped in. Once she was alone with the victim in a semi-public place, she would slash their throats and eviscerate them in a manner similar to that of Jack the Ripper. She would skillfully ignore the organs, a habit learned from her medical training.

After killing her victims, she would take trophies from them, such as items they acquired from the pubs they went to. Some victims were mutilated post-mortem in the same way the Ripper did to his. When she attempted to kill John, she consensually tied to a bed, tortured him by cutting him with a knife, and intended to mutilate him and presumably remove his heart post-mortem in a motel room in the same manner as the Ripper's last victim. She would also send letters that were typed and written in a language similar to the Ripper's and left some of them on the victims at the scene.

The unsub is a friendly and agile female (originally believed to be a homosexual male) between the ages of 30 and 35, who has low self-esteem that would be well-hidden. She would lure her victims in with charm and then kill them with rage. She would kill to reclaim her power and dress impeccably to keep the facade. Because she overcompensates to hide her insecurity, she most likely holds some position of authority at work and probably has some kind of medical training, such as a doctor, EMT, veterinarian, or such. Unlike Jack the Ripper, an impetuous lust killer, this offender would be organized, calculating, and maybe even stalk her victims for days before the actual murder. She might identify with the Ripper because she had lost his own identity, maybe through years of child abuse or a single catastrophic event. The French Quarter is her hunting ground and she knows the terrain well.

Despite copying the Ripper, her pathology is more similar to that of Aileen Wuornos, who, like the unusb, was motivated by paranoia and the fear of being sexually assaulted and used promises of sex to draw her victims close before killing them. She will approach her victims and is comfortable being the aggressor. Her writing "So many men, so little time" in one of her letters means she is on a quest to rid the world of men, possibly because her father molested her and it was believed the Ripper would mutilate his victims because he was sexually assaulted by his mother. Despite being enraged when killing, her letters show she is oddly apologetic for leaving a messy crime scene. Offenders typically write letters to be heard, but this unsub is not using correspondence to flaunt her latest kill, just to explain why she did it. It is possible that she considers herself a vigilante. She is contacting William LaMontagne, Sr., not because he was the lead detective on the case, but because she believes he would understand why she is killing. She may be a police officer or a prostitute he helped through a difficult time in her life. What the unsub wrote in her letters ("He was asking to be ripped", "I just couldn't help myself", "He wanted it") may mean she is mirroring the behavior of the men who raped her.

The trophies she took from her victims and kept in her apartment suggests she cannot move on from the rape and it is not her only stressor. It is likely she has a history of sexual abuse (possibly at the hands of her father when she was a child) that contributes to her rage as well. By taking on the Ripper persona, she is trying to kill something within herself.

October 8, 2006: Galveston, Texas: Leonard (one of his kidneys was removed post-mortem, like the Ripper did to Catherine Eddowes)

2007, New Orleans, Louisiana:

February 25: Unnamed victim

February 26: Mark

February 27: The "double homicide" (copied from the Ripper's double homicide of Elizabeth Stride and Catherine Eddowes):

Unnamed victim (the earlobe was cut off post-mortem, like the Ripper did to Catherine Eddowes)

Unnamed victim (left a letter in his mouth)

February 28: John (attempted; consensually tied to a bed, tortured by repeatedly cutting his chest, and intended to mutilate him and presumably take his heart post-mortem in a similar way to what the Ripper did to his final victim, Mary Jane Kelly)